title: Current diagnosis and management of urachal remnants.
abstract: OBJECTIVE
  The purposes of this study are to review our experience with patients who were found to have urachal remnants. We discuss their diagnosis and management and we also evaluate post-operative complications in our cohort of patients with this entity.
  
  
  METHODS
  We performed a retrospective review of all patients diagnosed with a urachal remnant (UR) between January 2006 and December 2010. Patient variables included age, gender, presenting symptoms and signs, diagnostic modality, and type of urachal remnant. Operative management, post-operative complications, and non-operative follow-up were abstracted.
  
  
  RESULTS
  We identified 103 pediatric patients with either a urachal cyst (n = 38), urachal diverticulum (n = 13), urachal sinus (n = 11), patent urachus (n = 21), or a non-specific atretic urachal remnant (n = 20). Seventy-eight patients had symptomatic URs. Thirty-four symptomatic patients underwent surgical excision of the UR and 44 symptomatic patients were observed. Eighteen URs were incidentally diagnosed in asymptomatic patients, none of whom underwent surgical excision. In 7 patients symptoms could not be determined from the records. No patients with non-specific atretic remnants were operated upon. Nineteen of the observed patients were reimaged subsequently. In fifteen (78.9%) of these patients, the URs had resolved spontaneously. None of the patients who were observed required subsequent excision of the UR. Post-operative complications occurred in 14.7% of patients in whom URs were excised.
  
  
  CONCLUSIONS
  Review of our patients diagnosed with URs indicates there is a subset of patients in whom spontaneous resolution could be expected. Complications are not uncommon after surgical excision.
authors.affiliation: Division of Pediatric Surgery, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL 60611, USA; Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
authors.forename: Jessica A
authors.initials: JA
authors.lastname: Naiditch
authors.forename: Jayant
authors.initials: J
authors.lastname: Radhakrishnan
authors.forename: Anthony C
authors.initials: AC
authors.lastname: Chin
mesh_terms: D002675:Child, Preschool; D004240:Diverticulum / Q000175:diagnosis / Q000601:surgery; D005260:Female; D006801:Humans; D033162:Incidental Findings; D007223:Infant; D008297:Male; D011183:Postoperative Complications / Q000453:epidemiology; D012075:Remission, Spontaneous; D012189:Retrospective Studies; D016896:Treatment Outcome; D014496:Urachal Cyst / Q000175:diagnosis / Q000601:surgery; D014497:Urachus / Q000002:abnormalities* / Q000601:surgery
keywords: Patent urachus; Umbilical discharge; Urachal cyst; Urachal diverticulum; Urachal remnant; Urachal sinus